The numbers of children and intravenous drug users (IVDU) of both sexes infected with HIV-1 are increasing. However, little is known about the oral manifestations of HIV-infection in these two groups, or about the potential for oral transmission of the virus. Therefore, the fourth subproject will focus on the prevalence of oral disease in a group of 800 heterosexual IVDU attending the Methadone Maintenance Treatment Program at BIMC. Oral disease will be correlated with HIV- status, the presence of HIV in serum and whole saliva, T4/T8 cell ratios, oral hygiene, and access to dental care. Subproject #5 will evaluate subgingival plaque microbiology in the same IVDU as well as in periodontal disease. Subproject #2 will focus on potential routes for transmission of HIV in the IVDU by determining viral levels in whole saliva and serum. In addition, a non-invasive method for determining HIV status using gingival crevicular fluid will continue to be refined. The pilot study will include a rigorous oral examination of HIV+ children as well as analyses of whole saliva for antibodies to certain viruses including CMV, EBV, HH6, HCV, and HIV. The ontogeny of HIV-specific salivary IgA will also be followed. Gingival crevicular fluid from pediatric subjects at risk for congenital HIV infection will be analyzed for HIV proviral DNA. The project is significant because it addresses the oral health problems of poorly studies groups using a multidisciplinary approach, and will provide information to help formulate dental policies in the future.